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PURPOSE: To investigate the factors associated with persistent serous retinal detachment in highly myopic eyes with inferior posterior staphyloma. METHODS: A total of 27 highly myopic patients (44 eyes) with an inferior posterior staphyloma were recruited. Serous retinal detachment was investigated; 13 eyes had persistent sub-macular fluid (study group), and 31 eyes lacked sub-macular fluid (control group). All patients underwent complete ophthalmologic examinations, including axial length measurement and fluorescein angiography (FA). Triton Deep Range Imaging (DRI) optical coherence tomography (OCT) (Topcon Corp., Tokyo, Japan) scans through the fovea measured choroidal thicknesses, macular bend height, and vitreoretinal interface factors. RESULTS: Of the 44 eyes, 13 had neurosensory retinal detachment and 31 did not. No significant differences were found in any of the studied variables (age, gender, spherical equivalence, axial length, vitreomacular traction, epiretinal membrane, internal limiting membrane detachment), except a higher macular bend height (p = 0.01), and a reduced macular choroidal thickness (p = 0.02), which were associated with the risk of serous retinal detachment. No statistically significant differences in best-corrected visual acuity (BCVA) were observed between the study and control groups. Serous retinal detachment always occurred at the bisected retinal pigment epithelium of the macula corresponding to the upper edge of the staphyloma, and was characterised by multiple hyperfluorescent granular patches on fluorescein angiography. CONCLUSIONS: A higher macular bend height and a reduced macular choroidal thickness may be important factors in the development of serous retinal detachment in patients with inferior posterior staphyloma.
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OBJECTIVE: To classify dome shaped macula cases by their bulge height (BH). To analyse the characteristics associated with the groups formed by this classification. METHODS: Observational, descriptive and cross-sectional study on 15 selected eyes with dome shaped macula and high myopia. Using Caillaux method and optical coherence tomography images, 3groups were determined by their BH: low (50-350 µ), medium (351-650 µ), and high (>650 µ), and a study of visual acuity, axial length, presence of subfoveal serous detachment, and images by fluorescein angiography and optic coherence tomography, as main variables. The confidence interval was 95%. RESULTS: By using the chi-squared test, the study showed that a BH higher than 400 µ was associated with lower visual acuity, presence of subfoveal serous detachment, and greater atrophy of the retinal pigment epithelium measured by disc diameters (P<.05). CONCLUSIONS: The medium and high BH showed a positive correlation with the presence of foveal serous detachment and a lower visual acuity.
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Mácula Lútea/patología , Desprendimiento de Retina/diagnóstico por imagen , Adulto , Atrofia , Estudios Transversales , Femenino , Angiografía con Fluoresceína , Humanos , Mácula Lútea/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Miopía/diagnóstico por imagen , Miopía/etiología , Miopía/patología , Oftalmoscopía , Desprendimiento de Retina/etiología , Epitelio Pigmentado de la Retina/patología , Índice de Severidad de la Enfermedad , Tomografía de Coherencia Óptica , Agudeza VisualRESUMEN
OBJECTIVE: To study the costs associated with high myopia (HM) with choroidal neovascularisation (mCNV) or without mCNV. METHODS: Observational, retrospective, cross-sectional, and multicentre study (HM and mCNV) conducted on adult patients. Annualised medical direct cost (MDC) from the perspective of the National Health System, the non-medical direct cost (nMDC) from the patient perspective, and productivity losses were calculated. RESULTS: A total of 137 mCNV and 48 HM patients were included (mean age [SD]: 55.1 [2.8] vs. 54.7 [13.8]; P=.2), with 80% women in both groups. The observation time (months) ranged from 17.9 (9.6) right eye (RE) and 20.0 (9.7), left eye (LE) in mCNV and 47.1 (21.5) RE/45.5 (20.7) LE in MM. A higher percentage of emergency room visits was observed in mCNV vs. HM patients (41.7 vs. 25%; P=.06) and retinal specialists (91.2 vs. 77.1%; P=.01). The MDC was higher in mCNV: 1,985 (95% CI: 1772-2198) vs. 356 (251-480) HM, P<.001. The nMDC was also higher in mCNV: 256 (11-524) vs. 19 (11-26) HM, P>.4. The number of affected eyes, the follow-up time, and the mCNV were factors associated with direct costs. The impact on work productivity was higher in mCNV (quite/very concerned): 27.7 vs. 10.4% HM. The mCNV showed a significant association with activity impairment (OR: 3.47, 95% CI: 10.101-1.195). CONCLUSIONS: mCNV involves higher medical costs than HM. In addition, mCNV patients have a greater need of care and assistive devices, and greater impact of the disease in their work productivity.
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Neovascularización Coroidal/economía , Costo de Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Miopía Degenerativa/economía , Medicina Estatal/economía , Absentismo , Adulto , Anciano , Inhibidores de la Angiogénesis , Neovascularización Coroidal/etiología , Neovascularización Coroidal/terapia , Estudios Transversales , Eficiencia , Femenino , Recursos en Salud/economía , Recursos en Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Miopía Degenerativa/complicaciones , Miopía Degenerativa/terapia , Visita a Consultorio Médico/economía , Visita a Consultorio Médico/estadística & datos numéricos , Derivación y Consulta/economía , Estudios Retrospectivos , Dispositivos de Autoayuda/economía , Dispositivos de Autoayuda/estadística & datos numéricos , EspañaRESUMEN
CASE REPORT: Myopic magna with narrow anterior chamber that presented with a secondary angle closure due to lorazepam. DISCUSSION: Angle closure usually occurs in predisposed patients and is triggered by precipitating factors. Many drugs routinely used in clinical practice could act as a factor responsible for the secondary angle closure.
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Antagonistas Colinérgicos/efectos adversos , Glaucoma de Ángulo Cerrado/inducido químicamente , Lorazepam/efectos adversos , Midriáticos/efectos adversos , Miopía/complicaciones , Acetazolamida/uso terapéutico , Antagonistas Colinérgicos/farmacología , Antagonistas Colinérgicos/uso terapéutico , Terapia Combinada , Depresión/tratamiento farmacológico , Dexametasona/uso terapéutico , Susceptibilidad a Enfermedades , Femenino , Humanos , Presión Intraocular/efectos de los fármacos , Iris/cirugía , Lorazepam/farmacología , Lorazepam/uso terapéutico , Midriáticos/uso terapéutico , Timolol/uso terapéutico , Tomografía de Coherencia Óptica , Pruebas del Campo Visual , Adulto JovenRESUMEN
OBJECTIVE: To study the correlation between the myopic refractive error and certain personality traits, and to determine whether there is a correlation between the degree of myopia and an increased frequency in personality disorders. METHODS: Cross-sectional observational multicenter study conducted on 82 subjects (26 men, 56 women) age over 18 years with myopia (spherical defect ≤ -0.5 D), with 30 subjects having high myopia (<-6 D). DATA COLLECTED: age and gender, academic level, result in the Neo PI-R personality test, autorefractometry, myopic pathology, and ophthalmological treatment. RESULTS: Correlation (Spearman's) between the magnitude of the spherical defect and the 5 personality traits studied in the total sample was not statistically significant: neuroticism (-0.057; P=.610), extroversion (-0.020; P=.857), openness (-0.032; P=.774), kindness (-0.060; P=.592), and responsibility (-0.034; P=.765). By dividing them into subgroups of low and high significance (t-test), a significant (P=.002) upward trend of the myopic defect with increasing scores on extraversion was found. When comparing high myopic subjects to the non-high myopic ones, there were significant differences between the 2 groups in terms of the associated pathology (P=.001), received treatment (P=.001) and the level of studies (P=.013). There were no differences in the variables of personality: neuroticism (P=.852), extroversion (P=.199), openness (P=.560), kindness (P=.584), and responsibility (P=.722). CONCLUSIONS: A low correlation was found between myopia and personality. There was no difference in the degree of myopia between the groups with different education levels. Subjects with more severe ocular pathology associated with myopia had higher scores in neuroticism, without finding any significant association.